Parent/legal guardian name

Address

List any medical, emotional, mental information that may affect your child during camp (medications, allergies, food allergies, emotional/mental needs, etc.)

Please provide any information that would be beneficial to know to make camp a better experience.

Please provide a list of adults/teens siblings/sitters who you give permission to pick up the participant and provide their contact information. Please indicate if you give permission for the participant to walk home.

Payment method(please indicate the method)   Zelle 704-491-4426 Live Anew venmo  amywalters2011         Check made out to Amy Walters  Cash

One week $225 Sibling $200

Second week $200 Sibling $200

Third week $200 Sibling $180

Fourth week $150 Sibling $150

Please review the waiver at the link below Waiver: Click here to view the waiver And sign your name below. Putting your name below acknowledges that you have read and agree to the terms stated in the waiver.